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经皮肾活检在大型原发性肾脏和肾移植受者队列中的并发症发生率和决定因素。

Incidence and Determinants of Complications of Percutaneous Kidney Biopsy in a Large Cohort of Native Kidney and Kidney Transplant Recipients.

机构信息

Department of Internal Medicine, Kasr Alainy University Hospital, Cairo, Egypt.

Department of Nephrology, Theodor Bilharz Institute, Cairo, Egypt.

出版信息

Sultan Qaboos Univ Med J. 2022 May;22(2):268-273. doi: 10.18295/squmj.5.2021.107. Epub 2022 May 26.

Abstract

OBJECTIVES

This study aimed to determine the incidence and factors associated with complications for kidney biopsy. Percutaneous kidney biopsy is a useful diagnostic procedure. Haemorrhagic complications may occur following the procedure.

METHODS

The present study retrospectively analysed the records of patients who had percutaneous renal biopsy between March 2013 and March 2018. The cohort included both native kidney and native transplant biopsies. We have included only the first biopsy for each patient; repeat biopsies were excluded from the analysis.

RESULTS

A total of 1,198 patients (332 transplant recipients and 886 native kidney patients) were included in this study. Major complications occurred in 1.5% (n = 18) of patients (1.4% in native kidney biopsies versus 1.6% in kidney transplant recipients). Adequate renal tissue (core of >6 glomeruli) was obtained in 91% of the patients. Data analysis revealed that the incidence of major complications in the native kidney biopsy increase with an age >65 years (odds ratio = 2.4; 95% Confidence interval [CI] = 1.5-5.6), estimated glomerular filtration rate (eGFR) <30 mL/min/m (odds ratio = 9.7; 95% CI = 3.4-18.2) and anaemia (odds ratio = 3.2; 95% CI = 1.7-5.2). In transplant recipients kidney biopsy, the incidence of complications was increased with age >65 years (odds ratio = 2.8; 95% CI = 1.7-7.3), eGFR <30 mL/min/m (odds ratio = 11.3; 95% CI = 3.5-16.8) and anaemia (odds ratio = 2.4; 95% CI = 1.4-4.7).

CONCLUSION

The incidence of major complications following kidney biopsy was 1.5% for a cohort of native kidney biopsy and kidney transplant biopsies. Age >65 years, lower eGFR <30 mL/min/m and anaemia were independent risk predictors for the occurrence of major complications in both native and transplant kidney biopsies.

摘要

目的

本研究旨在确定肾活检相关并发症的发生率及影响因素。经皮肾活检是一种有用的诊断程序,该操作后可能会发生出血并发症。

方法

本研究回顾性分析了 2013 年 3 月至 2018 年 3 月期间接受经皮肾活检的患者记录。该队列包括原发性肾脏和原发性移植活检。我们仅纳入每位患者的第一次活检;排除了重复活检的分析。

结果

共有 1198 名患者(332 名移植受者和 886 名原发性肾病患者)纳入本研究。1.5%(n=18)的患者发生严重并发症(原发性肾病活检为 1.4%,肾移植受者为 1.6%)。91%的患者获得了足够的肾组织(>6 个肾小球的核心)。数据分析显示,年龄>65 岁(优势比=2.4;95%置信区间[CI]:1.5-5.6)、肾小球滤过率(eGFR)<30ml/min/m(优势比=9.7;95%CI:3.4-18.2)和贫血(优势比=3.2;95%CI:1.7-5.2)的原发性肾病活检患者严重并发症发生率增加。在移植受者肾活检中,年龄>65 岁(优势比=2.8;95%CI:1.7-7.3)、eGFR<30ml/min/m(优势比=11.3;95%CI:3.5-16.8)和贫血(优势比=2.4;95%CI:1.4-4.7)的患者并发症发生率增加。

结论

原发性肾活检和肾移植活检的严重并发症发生率为 1.5%。年龄>65 岁、eGFR<30ml/min/m 和贫血是原发性和移植肾活检中严重并发症发生的独立危险因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a51d/9155023/e7f1a0318447/squmj2205-268-273f1.jpg

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